Albumin-Bilirubin grade predicts prognosis of HCC patients with sorafenib use

Yuan Hung Kuo, Jing Houng Wang, Chao Hung Hung, Kun Ming Rau, I. Pei Wu, Chien Hung Chen, Kwong Ming Kee, Tsung Hui Hu, Sheng Nan Lu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

54 Scopus citations


Background and Aim: The Albumin-Bilirubin (ALBI) grade is a new index to assess objectively liver function and prognosis in patients with hepatocellular carcinoma (HCC). This study aimed to elucidate the application of ALBI grade in baseline and sorafenib-end in advanced HCC patients who received sorafenib. Methods: A total of 415 consecutive advanced HCC patients in Child–Pugh A received sorafenib in our hospital. Sorafenib was terminated when radiologic tumor progression or clinical liver function deterioration (LD) occurred in the reassessment bimonthly. Patients who failed with sorafenib monotherapy were retrospectively analyzed. Results: A total of 260 (62.6%) patients were enrolled, including 98 (37.7%) ALBI grade I and 162 (62.3%) grade II in baseline. More patients in ALBI grade II stopped sorafenib because of LD than in grade I (33.3% vs 14.3%, P < 0.001). Those who in baseline ALBI grade I had a superior overall survival than in grade II (8.5 months vs 4.4 months, P = 0.003). Cox regression analysis confirmed that baseline ALBI grade II (P < 0.001) and ALBI grade increase during treatment (P < 0.001) strongly contributed to the mortality of HCC patients who received sorafenib. After sorafenib failure, those with post-sorafenib treatment had a better post-sorafenib survival than those without (9.3 vs 1.6 months, P < 0.001). Logistic regression analysis indicated that sorafenib-end ALBI grade and LD occurrence were the only two predictors of post-sorafenib treatment after sorafenib failure. Conclusions: In clinical practice, we firstly demonstrated that not only ALBI grade in baseline but also ALBI grade change during treatment could predict the prognosis of advanced HCC patients who received sorafenib.

Original languageEnglish
Pages (from-to)1975-1981
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Issue number12
StatePublished - 12 2017

Bibliographical note

Publisher Copyright:
© 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.


  • Albumin-Bilirubin grade
  • hepatocellular carcinoma
  • post-sorafenib treatment
  • sorafenib


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